Rare Complex Surgery Performed Successfully at Dr. Mehta’s Hospitals

Dr. Mehta’s Hospitals has accomplished a remarkable feat by successfully treating a young girl diagnosed with an extraordinarily rare and complex form of Type-1 Choledochal Cyst that had been complicated with perforations in the common bile duct and gallbladder. This was a unique case because of the high grade of adhesions and the complexity of the condition.

This patient has been diagnosed with Type 1 Choledochal Cyst, characterized by the dilation of the common bile duct. In this case, her condition was further compounded by the fact that she had perforations in the common bile duct and the gallbladder. This combination is unusual, and it has not been previously documented in medical literature. This particular case of Choledochal cyst, presenting with multiple perforations, made it an unprecedented challenge.

Upon her admission at Dr Mehta’s Hospitals, the team led by Dr. Thangavelu, Director of Pediatrics and Senior Consultant, and Pediatric Gastroenterologist Dr. Sumathi conducted a thorough evaluation. Upon assessment, they found a type 1 Choledochal Cyst with inflamed porta hepatis where the hepatic artery and portal vein enter the liver and multiple periportal lymph nodes, indicating significant inflammatory changes. Additionally, the CBD area was tightly adhered to the portal vein, with dense adhesions of the small bowel. Surgery is the gold-standard treatment option for this condition. The presence of the perforations made the condition exceptionally difficult to manage intraoperatively. These complications made it extremely challenging to perform a safe and effective surgical intervention without causing damage to vital organs.

Dr. Raghul, the lead and senior consultant Pediatric surgeon, and his team, including Dr. Saravanan and Pediatric Anaesthetist Dr. Karthikeyan, undertook the intricate and complex surgery. The operation required delicate dissection to separate the adhesions and manage the complex interactions between the perforated regions and surrounding vital structures. Despite the difficulties, the team smoothly & successfully was able to navigate the frozen areas without damaging the intestines or major organs and executed Choledochal Cyst Excision combined with Roux-en-Y hepaticojejunostomy and jejunojejunostomy with precision. The postoperative recovery was smooth and free of any complications, with the young patient maintaining hemodynamic stability throughout her post-operative period.

“This surgery is a significant achievement,” said Dr. Saravana Kumar, Group Unit Head of Dr. Mehta’s Hospitals, praising the team’s exceptional handling of complicated cases with precision and expertise.

“Choledochal Cysts need a high index of suspicion in children. Delayed treatment/mismanagement may lead to hazardous complications,” said Dr Raghul, Senior Consultant Pediatric surgeon of Dr. Mehta’s Hospitals, Chetpet.

This extraordinary case not only highlights the advanced surgical capabilities of Dr. Mehta’s Hospitals but also underscores the exceptional skill and dedication of its medical professionals in overcoming unprecedented medical challenges.